Home Health Care Services (HHCS) Providers and FMSAs Must Submit EVV HHCS Claims to TMHP

Date: November 21, 2023

Attention: STAR Kids Providers/Consumer Directed Services employers and FMSA Providers

Effective Date: December 1, 2023

Call to action: Texas Children’s Health Plan (TCHP) would like to remind providers that the Home Health Care Services (HHCS) are found in the Programs, Services and Service Delivery Options Required to Use Electronic Visit Verification by Jan. 1, 2024 document.  The EVV HHCS Service Bill Codes Table is posted on the EVV 21st Century Cures Act web page in Excel and PDF formats.  

Claims Submission

On June 1, 2023, the Texas Medicaid & Healthcare Partnership (TMHP) started receiving providers, Financial Management Services Agencies (FMSAs), and CDS employers HHCS EVV claims for claims matching.

Claims Submission Cutover Date 

Providers and FMSAs must submit all HHCS EVV claims starting with dates of service on or after Dec. 1, 2023 to TMHP using TexMedConnect, or through Electronic Data Interchange (EDI) using a Compass 21 (C21) Submitter ID.

Claims Matching

For dates of service on Dec. 1, 2023, through Dec. 31, 2023, providers and FMSAs submitting their HHCS EVV claims through TMHP will receive both an informational EVV claims match result (EVV07) and an actual claim match result for HHCS EVV claims (EVV01 through EVV06). The actual claims match results and the informational claims match results will be viewable in the EVV Portal. During this time, TMHP will forward all HHCS EVV claims received to TCHP with an EVV07 match code.

Next steps for providers: Providers are encouraged to share this communication with their staff.

If you have any questions, please email Provider Relations at: providerrelations@texaschildrens.org.

For access to all provider alerts,log into:
www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers.